Application Form for Integrative Health Coach Training

Application instructions for SELF-PACED INTEGRATIVE HEALTH COACH TRAINING PROGRAM

Have you already downloaded our INFORMATION KIT?
Applicants will be notified via email within 48 hours and may possibly be asked to schedule a brief phone call with Dr. Nickerson.
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PLEASE NOTE: If your application is approved, you will be emailed a consent form and a payment link.

Which program are you interested in taking? I am applying for the Self-Paced Integrative Health Coach Training Program I am also interested in the Corporate Integrative Health Coach Training ProgramI am also interested in the Highly Sensitive Person Certification CourseI am also interested in the Conscious Healing CourseLegal NameStreet Address CityState/Province, Zip/Postal CodePhone Number (where you prefer to be contacted, if needed)Email AddressBirthdate Education (please include your field of study)Previous Experience (list only those roles that are relevant to your participating in the Integrative Health Coach Training Program)Medical Conditions (optional)Tell us about your interest in mind-body-spirit health and wellness. What life events transpired to bring you here?How would you like to apply your health coach training in your professional life? (working in a health organization, private practice, supplement your current position)Are you currently working? If so, in what profession?How do you best like to learn? (Visual, auditory, reading? Group discussions or individual?)How did you hear about this course?If approved, what date do you intend to start the course?Today's Date

By submitting this application, I confirm that the information given in this form is complete and accurate.

Thank you! Your submission has been received! You will be contacted with 48 hours.

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Application Form

for Integrative Health Coach Training Program

Application instructions for SELF-PACED INTEGRATIVE HEALTH COACH TRAINING PROGRAM

PLEASE NOTE: If your application is approved, you will be emailed a consent form and a payment link.